WASHROOM SPECIFICATION
it, in accordance with Health Technical Memorandum 04-01. Clinical handwash basins should be installed in all clinical areas. Washing is carried out under running water, and therefore a medium or large integral back-outlet basin with no plug is recommended.
Health Technical Memoranda In addition to the Health Building Notes, the Government’s Health Technical Memorandum (HTM) series gives comprehensive advice and guidance on the design, installation, and operation, of specialised building and engineering technology used in the delivery of healthcare. It is applicable to new and existing sites, and is for use at various stages during the whole building lifecycle. The Health Technical Memoranda provide best practice engineering standards and policy to enable healthcare providers to manage their duty of care to ensure safety and appropriate governance. The series is vast, with a number of guidance documents covering all aspects of the building.
In relation to sanitaryware and sanitary fitting design, the relevant HTMs highlight the issue of safe water, with the guidance covering scalding, water hygiene, and infection control. This is all covered in HTM 04-01: Safe water in healthcare premises, which itself consists of three parts (A, B and C – explored below) plus one supplement, D08, which focuses on the performance specification of thermostatic mixing valves in healthcare premises. Together, the three parts cover the design, installation, commissioning, testing, monitoring, and operation, of water supply systems in healthcare premises.
Hygienic wall-hung toilets are made possible thanks to ‘quick and affordable’ pre-frame systems such as Geberit Duofix, shown with a Geberit flushplate.
HTM 04-01 Part A
Part A relates specifically to design, installation, and commissioning, focusing on the risk of scalding for vulnerable patients, which includes young children and older people, disabled people, and those with neuropathy. This is of particular concern in healthcare premises caring for such individuals, and therefore thermostatic mixing devices could be needed for hot water outlets.
Wherever handwash basins are installed, a mixed water temperature outlet is required, and a risk assessment – which considers the needs of patients and service-users to determine whether there is a scalding risk – should be undertaken. Part A also states that showerheads where the flow can be adjusted by selecting different sets of nozzles should not be installed in healthcare premises, because this will exacerbate possible stagnation problems.
HTM 04-01 Part B
Part B of HTM 04-01 relates to operational management, including the measures required to prevent the spread of Legionella bacteria. This guidance notes the traditional means of controlling Legionella in hot and cold water services, including by using a temperature control regime. Hot and cold water systems should be maintained to keep cold water, where possible, at a temperature below 20˚C, and to keep hot water stored at 60˚C and distributed so that it reaches the outlets at 55˚C within one minute. HTM 04-01 Part B also introduces the notion of a Water Safety Group (WSG) within each healthcare organisation, which is crucial for governance and standards. The WSG is a multidisciplinary group formed to oversee the commissioning, development, implementation, and review, of the WSP (Water Safety Plan), which should have final agreement on any decisions affecting the safety and integrity of water systems and associated equipment. Its aim is to ensure the safety of all water used by patients, residents, staff, and visitors, to minimise the risk of infection associated with waterborne pathogens.
June 2021 Health Estate Journal 61
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